US health officials appear to shy away from anti-vaccine talk ahead of midterms

US health officials appear to be shying away from voicing negative views of vaccines in public as November’s midterm elections loom and key polling indicates anti-vaccine views are a liability.Health officials have made unprecedented changes to routine vaccine recommendations in the past year – slashing one-third of the US childhood schedule, including the recommendation for hepatitis B immunization at birth. But even before a federal judge essentially invalidated these moves, officials haven’t championed their dramatic changes after Donald Trump’s pollsters recommended veering away from anti-vaccine ideology ahead of the midterms.The elections seem top-of-mind for US health officials. At a conference on women’s health in March sponsored by the US Department of Health and Human Services (HHS), Marty Makary, commissioner of the US Food and Drug Administration (FDA), referenced support from the “Make America healthy again” (Maha) movement in the 2024 election.“Moms showed up to vote for the Maha agenda,” he said.At the conservative CPAC conference at the end of March, Robert F Kennedy Jr, the HHS secretary and longtime vaccine opponent, didn’t explicitly mention immunizations once in his 30-minute “fireside chat” with Mercedes Schlapp, one of the organizers of the conference. When Schlapp asked Kennedy what advice he would give to “Maha moms” or “Maha parents,” Kennedy didn’t default to his two decades of rhetoric about toxic exposures and vaccines. Instead, he said: “The biggest threats that we’re facing now are cell phones and social media.”When asked about his successes in the past year and priorities moving forward, Kennedy talked about bringing back the food pyramid and flipping it, and removing nine synthetic food dyes. Though updating baby formula is a stated priority, health agencies have made little progress on it.The administration hasn’t gotten to the “root cause” of health issues, said Katelyn Jetelina, founder of Your Local Epidemiologist; instead, they’ve been “headline wins”, she said. The health secretary’s Maha loyalists were also thrown into tumult earlier this year when Trump signed an executive order on glyphosate, an herbicide sold as Roundup that the Maha movement opposes.Among the Maha grassroots, vaccines aren’t as big a concern as environmental and nutritional issues, Jetelina said.“Obviously it’s something that’s really personal to RFK, who’s built a career and history around that,” she said. Yet for the average Maha voter, “it sure seems like they’re moving away” from opposition to vaccines, she added.Among voters surveyed in the 35 most competitive congressional districts, there was “strong bipartisan support for routine childhood vaccines”, Tony Fabrizio and Bob Ward wrote in December – and that holds across the Maha movement, they found, with most Maha voters rejecting changes to childhood immunizations. These “high levels of trust in vaccines” mean “skepticism toward vaccine requirements is politically risky for both parties”, they concluded.“My perception is absolutely that messaging has gone out to downplay anti-vaccine messaging,” said Elizabeth Jacobs, an epidemiology professor at the University of Arizona and a founding member of Defend Public Health. “It seems like somebody has advised him to stop doing anti-vaccine stuff.”But Kennedy did make quiet references to his long-held anti-vaccine ideologies. He “had been watching this deterioration in the health of our children, the rise of chronic disease, since 2005”, he said. That’s the year Kennedy penned an explosive article for Rolling Stone and Salon – later retracted by Salon – claiming vaccines cause autism.The reference is “a major glaring sign that he is talking about vaccines, for sure”, said Jacobs. Kennedy has blamed higher recognized rates of autism – widely believed to be the result of improvements in diagnoses – upon vaccines, despite dozens of studies finding no link.“I never knew anybody with autism,” Kennedy said at CPAC. “Suddenly they’re everywhere.”He did not mention the changes in how autistic people receive support, with a greater emphasis on providing care within the community instead of institutionalizing them out of sight, as was common during Kennedy’s childhood.“And when I started talking about it, I got censored. And I prayed every day for 19 years that God would put me in a position to change this,” he said. Under Kennedy, the US ended full recommendations on shots to protect against the flu, rotavirus, respiratory syncytial virus (RSV) and others.Kennedy in the past year “was a bull in the china shop. They just broke everything,” Jacobs said.Jay Bhattacharya, head of the National Institutes of Health (NIH), only mentioned shots once at CPAC – to highlight the potential for shingles vaccination to protect against developing Alzheimer’s disease.“Researchers are investigating whether a shingles vaccine, a vaccine that I took a while ago, might actually reduce the risk of Alzheimer’s disease,” he said. But he also repeatedly echoed Kennedy’s rhetoric on “chronic disease”, a phrase Kennedy frequently uses to refer to autism. “Despite all our scientific progress, I know we are in the middle of a chronic disease crisis,” he said.Ideological allies have continued to push publicly against vaccines, with Mark Gorton, president of the Maha Institute, recently calling for an end to all immunizations in the US.“The childhood vaccination schedule needs to be eliminated. And all vaccines need to be removed from the market until they can be proven to be both safe and effective,” Gorton said in March.At the same Maha Institute event, Del Bigtree, a longtime Kennedy ally and prominent anti-vaccine activist, said: “We’re winning,” and urged followers to “be loud and more proud than you’ve ever been”. Brian Hooker, chief scientific officer at Children’s Health Defense, the organization led by Kennedy until recently, told NPR that anti-vaccine ideology is “in the forefront” and “on the agenda” for US health officials.Even if officials have temporarily cut back on direct discussion of vaccines, misinformation continues to spread alongside measles and other preventable illnesses as vaccination levels drop, Jetelina said.“We are going to lose lives over this,” she said. “We are going backwards on a lot of things, and we don’t have time to be spinning our wheels.”